Intraoperative Administration of Diphenhydramine Attenuates Postoperative Catheter Related Bladder Discomfort in Patient Following Percutaneous Nephrolithotomy
Abstract
Background: We intend to evaluate the effect of intraoperative diphenhydramine administration on incidence and severity of catheter related bladder discomfort (CRBD) and pain after percutaneous nephrolithotomy.
Methods: In a double blind randomized clinical trial, adult male patients undergoing percutaneous nephrolithotomy were enrolled. They were randomized into two groups by a computerized digital random allocation method. Before anesthesia induction, group D (Diphenhydramine group) (n = 48) received 5 ml normal saline containing 0.5 mg/kg of diphenhydramine intravenously. In group C (Control group) (n = 48), 5 ml of normal saline was injected in the same manner. Induction and maintenance of anesthesia were identical in both groups. The incidence and severity of CRBD and postoperative pain were assessed at recovery room.
Results: The incidence of CRBD was significantly lower in group D than in group C (14% vs. 63%, P=0.001). The severity of CRBD was milder in group D in comparison to group C (P<0.05). Postoperative pain score was significantly lower in group D (P<0.05).
Conclusion: Intraoperative administration of diphenhydramine is an effective practice for the prevention of CRBD after percutaneous nephrolithotomy in male patients and can reduce postoperative pain as well.
[1] Mohammadi A, Nikoobakht MR, Akhavizadegan H, Kazem Aghamir SM, Inanloo SH, Nosrati F. How a renal artery aneurysm may mimic renal stone? Urol Case Rep. 2021; 37:101621.
[2] Ziaee AM, Akhavizadegan H, Karbakhsh M. Effect of allopurinol in chronic nonbacterial prostatitis: a double blind randomized clinical trial. Int Braz J Urol. 2006; 32(2):181-6.
[3] Jang EB, Hong SH, Kim KS, Park SY, Kim YT, Yoon YE, et al. Catheter-Related Bladder Discomfort: How can we manage it? Int Neurourol J. 2020; 24(4):324-331.
[4] In CB, Lee SJ, Sung TY, Cho CK, Jee YS. Effects of Chlorpheniramine Maleate on Catheter-Related Bladder Discomfort in Patients Undergoing Ureteroscopic Stone Removal: A Randomized Double-Blind Study. Int J Med Sci. 2021; 18(4):1075-1081.
[5] Inanloo SH, Nikoobakht MR, Akhavizadegan H, Karbakhsh M. Ultrasound Guided Percutaneous Nephrolithotomy in Mesh-Repaired Incisional Hernia. Adv Urol. 2021; 2021:1537840.
[6] Li C, Liu Z, Yang F. Predictors of catheter-related bladder discomfort after urological surgery. Journal of Huazhong University of Science and Technology [Medical Sciences]. 2014; 34(4):559-62.
[7] Xiaoqiang L, Xuerong Z, Juan L, Mathew BS, Xiaorong Y, Qin W, et al. Efficacy of pudendal nerve block for alleviation of catheter-related bladder discomfort in male patients undergoing lower urinary tract surgeries: A randomized, controlled, double-blind trial. Medicine. 2017; 96(49).
[8] Sabetian G, Zand F, Asadpour E, Ghorbani M, Adibi P, Hosseini MM, et al. Evaluation of hyoscine N-butyl bromide efficacy on the prevention of catheter-related bladder discomfort after transurethral resection of prostate: a randomized, double-blind control trial. Int Urol Nephrol. 2017; 49(11):1907-13.
[9] Hu B, Li C, Pan M, Zhong M, Cao Y, Zhang N, et al. Strategies for the prevention of catheter-related bladder discomfort: A PRISMA-compliant systematic review and meta-analysis of randomized controlled trials. Medicine. 2016; 95(37): e4859.
[10] Khajavi MR, Kamalzadeh N, Pourfakhr P, Moharari RS, Etezadi F. The Efficacy of Intraoperative Ketamine-Haloperidol for Prevention of Catheter-related Bladder Discomfort After Lumbar Spinal Stenosis Surgery. Oman Med J. 2019; 34(3):212-7.
[11] Etezadi F, Sajedi Y, Khajavi MR, Moharari RS, Amirjamshidi A. Preemptive Effect of Intraurethral Instillation of Ketamine–lidocaine Gel on Postoperative Catheter-related Bladder Discomfort after Lumbar Spine Surgery. Asian J Neurosurg. 2018; 13(4):1057-60.
[12] Pourfakhr P, Aghabagheri M, Zabihi Mahmoudabadi H, Najjari K, Talebpour M, Khajavi MR. Prophylactic Administration of Diphenhydramine/Acetaminophen and Ondansetron Reduced Postoperative Nausea and Vomiting and Pain Following Laparoscopic Sleeve Gastrectomy: A Randomized Controlled Trial. Obes Surg. 2021; 31(10):4371-5.
[13] Pourfakhr P, Ziaei SH, Etezadi F, Khajavi MR, Sharifnia MR. Diphenhydramine definitely suppresses fentanyl-induced cough during general anesthesia induction: a double-blind, randomized, and placebo-controlled study. Acta Medica Iranica. 2019; 316-9.
[14] Li YY, Zeng YS, Chen JY, Wang KF, Hsing CH, Wu WJ, et al. Prophylactic diphenhydramine attenuates postoperative catheter-related bladder discomfort in patients undergoing gynecologic laparoscopic surgery: a randomized double-blind clinical study. J Anesth. 2020; 34(2):232-237.
[15] Khajavi MR, Saffarian A, Majidi F, Moharari RS, Pourfakhr P, Parhiz SA. Prophylactic administration of diphenhydramine/paracetamol reduced emergence agitation and postoperative pain following maxillofacial surgeries: a randomized controlled trial. Eur Arch Otorhinolaryngol. 2022; 279(3):1467-1471.
[16] Pour-Rashidi A, Mardani M, Etezadi F, Moharari RS, Khajavi MR. The Effect of Intraoperative Diphenhydramine/Morphine on Acute Pain and Opioid Consumption after Spine Surgery. Arch Anesth & Crit Care. 2022; 8(1):36-40.
[17] Church MK, Church DS. Pharmacology of antihistamines. Indian journal of dermatology. 2013; 58(3):219.
[18] Li YY, Zeng YS, Chen JY, Wang KF, Hsing CH, Wu WJ, et al. Prophylactic diphenhydramine attenuates postoperative catheter-related bladder discomfort in patients undergoing gynecologic laparoscopic surgery: a randomized double-blind clinical study. J Anesth. 2020; 34(2):232-7.
[19] Hur M, Park SK, Yoon HK, Yoo S, Lee HC, Kim WH, et al. Comparative effectiveness of interventions for managing postoperative catheter-related bladder discomfort: a systematic review and network meta-analysis. J Anesth. 2019; 33(2):197-208.
[20] Ergenoglu P, Akin S, Cok OY, Eker E, Kuzgunbay B, Turunc T, et al. Effect of intraoperative paracetamol on catheter-related bladder discomfort: a prospective, randomized, double-blind study. Curr Ther Res Clin Exp. 2012; 73(6):186-94.
[21] Shariat Moharari R, Lajevardi M, Khajavi M, Najafi A, Shariat Moharari G, Etezadi F. Effects of Intra‐Operative Ketamine Administration on Postoperative Catheter‐Related Bladder Discomfort: A Double‐Blind Clinical Trial. Pain Pract. 2014; 14(2):146-50.
[22] Agarwal A, Dhiraaj S, Singhal V, Kapoor R, Tandon M. Comparison of efficacy of oxybutynin and tolterodine for prevention of catheter related bladder discomfort: a prospective, randomized, placebo-controlled, double-blind study. Br J Anaesth. 2006; 96(3):377-80.
[23] Agarwal A, Yadav G, Gupta D, Singh PK, Singh U. Evaluation of intra-operative tramadol for prevention of catheter-related bladder discomfort: a prospective, randomized, double-blind study. Br J Anaesth. 2008; 101(4):506-10.
[24] Agarwal A, Dhiraaj S, Pawar S, Kapoor R, Gupta D, Singh PK. An evaluation of the efficacy of gabapentin for prevention of catheter-related bladder discomfort: a prospective, randomized, placebo-controlled, double-blind study. Anesth Analg. 2007; 105(5):1454-7.
[25] Tabibi A, Akhavizadegan H, Nouri-Mahdavi K, Najafi-Semnani M, Karbakhsh M, Niroomand AR. Percutaneous nephrolithotomy with and without retrograde pyelography: a randomized clinical trial. Int Braz J Urol. 2007; 33(1):19-22.
[2] Ziaee AM, Akhavizadegan H, Karbakhsh M. Effect of allopurinol in chronic nonbacterial prostatitis: a double blind randomized clinical trial. Int Braz J Urol. 2006; 32(2):181-6.
[3] Jang EB, Hong SH, Kim KS, Park SY, Kim YT, Yoon YE, et al. Catheter-Related Bladder Discomfort: How can we manage it? Int Neurourol J. 2020; 24(4):324-331.
[4] In CB, Lee SJ, Sung TY, Cho CK, Jee YS. Effects of Chlorpheniramine Maleate on Catheter-Related Bladder Discomfort in Patients Undergoing Ureteroscopic Stone Removal: A Randomized Double-Blind Study. Int J Med Sci. 2021; 18(4):1075-1081.
[5] Inanloo SH, Nikoobakht MR, Akhavizadegan H, Karbakhsh M. Ultrasound Guided Percutaneous Nephrolithotomy in Mesh-Repaired Incisional Hernia. Adv Urol. 2021; 2021:1537840.
[6] Li C, Liu Z, Yang F. Predictors of catheter-related bladder discomfort after urological surgery. Journal of Huazhong University of Science and Technology [Medical Sciences]. 2014; 34(4):559-62.
[7] Xiaoqiang L, Xuerong Z, Juan L, Mathew BS, Xiaorong Y, Qin W, et al. Efficacy of pudendal nerve block for alleviation of catheter-related bladder discomfort in male patients undergoing lower urinary tract surgeries: A randomized, controlled, double-blind trial. Medicine. 2017; 96(49).
[8] Sabetian G, Zand F, Asadpour E, Ghorbani M, Adibi P, Hosseini MM, et al. Evaluation of hyoscine N-butyl bromide efficacy on the prevention of catheter-related bladder discomfort after transurethral resection of prostate: a randomized, double-blind control trial. Int Urol Nephrol. 2017; 49(11):1907-13.
[9] Hu B, Li C, Pan M, Zhong M, Cao Y, Zhang N, et al. Strategies for the prevention of catheter-related bladder discomfort: A PRISMA-compliant systematic review and meta-analysis of randomized controlled trials. Medicine. 2016; 95(37): e4859.
[10] Khajavi MR, Kamalzadeh N, Pourfakhr P, Moharari RS, Etezadi F. The Efficacy of Intraoperative Ketamine-Haloperidol for Prevention of Catheter-related Bladder Discomfort After Lumbar Spinal Stenosis Surgery. Oman Med J. 2019; 34(3):212-7.
[11] Etezadi F, Sajedi Y, Khajavi MR, Moharari RS, Amirjamshidi A. Preemptive Effect of Intraurethral Instillation of Ketamine–lidocaine Gel on Postoperative Catheter-related Bladder Discomfort after Lumbar Spine Surgery. Asian J Neurosurg. 2018; 13(4):1057-60.
[12] Pourfakhr P, Aghabagheri M, Zabihi Mahmoudabadi H, Najjari K, Talebpour M, Khajavi MR. Prophylactic Administration of Diphenhydramine/Acetaminophen and Ondansetron Reduced Postoperative Nausea and Vomiting and Pain Following Laparoscopic Sleeve Gastrectomy: A Randomized Controlled Trial. Obes Surg. 2021; 31(10):4371-5.
[13] Pourfakhr P, Ziaei SH, Etezadi F, Khajavi MR, Sharifnia MR. Diphenhydramine definitely suppresses fentanyl-induced cough during general anesthesia induction: a double-blind, randomized, and placebo-controlled study. Acta Medica Iranica. 2019; 316-9.
[14] Li YY, Zeng YS, Chen JY, Wang KF, Hsing CH, Wu WJ, et al. Prophylactic diphenhydramine attenuates postoperative catheter-related bladder discomfort in patients undergoing gynecologic laparoscopic surgery: a randomized double-blind clinical study. J Anesth. 2020; 34(2):232-237.
[15] Khajavi MR, Saffarian A, Majidi F, Moharari RS, Pourfakhr P, Parhiz SA. Prophylactic administration of diphenhydramine/paracetamol reduced emergence agitation and postoperative pain following maxillofacial surgeries: a randomized controlled trial. Eur Arch Otorhinolaryngol. 2022; 279(3):1467-1471.
[16] Pour-Rashidi A, Mardani M, Etezadi F, Moharari RS, Khajavi MR. The Effect of Intraoperative Diphenhydramine/Morphine on Acute Pain and Opioid Consumption after Spine Surgery. Arch Anesth & Crit Care. 2022; 8(1):36-40.
[17] Church MK, Church DS. Pharmacology of antihistamines. Indian journal of dermatology. 2013; 58(3):219.
[18] Li YY, Zeng YS, Chen JY, Wang KF, Hsing CH, Wu WJ, et al. Prophylactic diphenhydramine attenuates postoperative catheter-related bladder discomfort in patients undergoing gynecologic laparoscopic surgery: a randomized double-blind clinical study. J Anesth. 2020; 34(2):232-7.
[19] Hur M, Park SK, Yoon HK, Yoo S, Lee HC, Kim WH, et al. Comparative effectiveness of interventions for managing postoperative catheter-related bladder discomfort: a systematic review and network meta-analysis. J Anesth. 2019; 33(2):197-208.
[20] Ergenoglu P, Akin S, Cok OY, Eker E, Kuzgunbay B, Turunc T, et al. Effect of intraoperative paracetamol on catheter-related bladder discomfort: a prospective, randomized, double-blind study. Curr Ther Res Clin Exp. 2012; 73(6):186-94.
[21] Shariat Moharari R, Lajevardi M, Khajavi M, Najafi A, Shariat Moharari G, Etezadi F. Effects of Intra‐Operative Ketamine Administration on Postoperative Catheter‐Related Bladder Discomfort: A Double‐Blind Clinical Trial. Pain Pract. 2014; 14(2):146-50.
[22] Agarwal A, Dhiraaj S, Singhal V, Kapoor R, Tandon M. Comparison of efficacy of oxybutynin and tolterodine for prevention of catheter related bladder discomfort: a prospective, randomized, placebo-controlled, double-blind study. Br J Anaesth. 2006; 96(3):377-80.
[23] Agarwal A, Yadav G, Gupta D, Singh PK, Singh U. Evaluation of intra-operative tramadol for prevention of catheter-related bladder discomfort: a prospective, randomized, double-blind study. Br J Anaesth. 2008; 101(4):506-10.
[24] Agarwal A, Dhiraaj S, Pawar S, Kapoor R, Gupta D, Singh PK. An evaluation of the efficacy of gabapentin for prevention of catheter-related bladder discomfort: a prospective, randomized, placebo-controlled, double-blind study. Anesth Analg. 2007; 105(5):1454-7.
[25] Tabibi A, Akhavizadegan H, Nouri-Mahdavi K, Najafi-Semnani M, Karbakhsh M, Niroomand AR. Percutaneous nephrolithotomy with and without retrograde pyelography: a randomized clinical trial. Int Braz J Urol. 2007; 33(1):19-22.
| Files | ||
| Issue | Vol 10 No 3 (2024): Summer |
|
| Section | Research Article(s) | |
| DOI | https://doi.org/10.18502/aacc.v10i3.15693 | |
| Keywords | ||
| Catheter-related bladder discomfort Diphenhydramine Postoperative pain nephrolithotomy | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Khajavi MR, Maroofian M, Akhavizadegan H. Intraoperative Administration of Diphenhydramine Attenuates Postoperative Catheter Related Bladder Discomfort in Patient Following Percutaneous Nephrolithotomy. Arch Anesth & Crit Care. 2023;10(3):247-251.
